Introduction: The Glove Rehabilitation Application for Stroke Patients (GRASP) Fast-Track SBIR program will promote recovery of hand function following stroke through an instrumented orthosis that enables functional practice of manual tasks in fun and engaging activities within a virtual environment. The effort combines patented sensor glove technology developed under the NASA space suit program with a commercial hand orthosis and modern game engine technology. GRASP will automatically assess a patient?s functional level and adapt the challenge to his/her capabilities. In each session, the system will automatically produce valid metrics of hand function, providing both patients and providers with immediate feedback on status and progress. The low-cost product will support independent home use as well as serve as part of a therapistguided in-patient, skilled nursing, outpatient, home health, or teletherapy rehabilitation program. Problem to be addressed: GRASP addresses the critical challenges of: (1) improving outcomes in hand therapy through task-directed practice and mental imagery that promote functional recovery; (2) enabling increased dosage, intensity, and duration through independent home use and teletherapy; (3) minimizing total cost of rehabilitation by reducing patient/therapist travel; and (4) improving services in underserved areas. Long-Term Goal: Improved outcomes and functional independence for patients with acquired brain injury. Phase I Summary: Phase I of the Fast-Track will produce a prototype system that consists of a sensor package and software application that permits a commercial glove orthosis to be used for practice of virtual activities of daily living (ADLs) in a compelling virtual world. A pilot study conducted by the University of Virginia (UVa), UVa HealthSouth Rehabilitation Hospital, and Continuum Home Health will investigate the primary Phase I hypothesis, which states that GRASP-generated metrics correlate significantly with accepted measures of hand function. Two Phase I case studies led by home health therapists will explore usability in the home environment and serve as pathfinders for Phase II efficacy trials. Phase II Summary: Phase II of the Fast-Track will include: (1) development of a commercial system; (2) extension of the range of hand therapy activities and expansion of virtual environments to provide an engaging and motivating experience across 8 weeks of treatment; (3) provider tools for prescribing and monitoring status/progress; and (4) teletherapy interfaces. A Phase II efficacy study will investigate improvement in standardized assessment scores and adherence for GRASP at-home therapy vs. standard care. Randomized, controlled trials will be led by UVa in partnership with HealthSouth and Continuum Home Health. Commercial Opportunity: Approximately 50% of the 800,000 individuals hospitalized due to stroke each year in the U.S. suffer from chronic deficits in hand and/or arm function [1], [2]. GRASP is poised to rapidly transition evidence-based research to market by leveraging an existing brand with well-defined distribution channels.